Psychosocial outcomes of children with ear infections and hearing problems:A longitudinal study

Background\ud \ud There is some evidence of a relationship between psychosocial health and the incidence of ear infections and hearing problems in young children. There is however little longitudinal evidence investigating this relationship. This paper used 6-year prospective longitudinal data to examine the impact of ear infection and hearing problems on psychosocial outcomes in two cohorts of children (one cohort recruited at 0/1 years and the other at 4/5 years).\ud \ud Methods\ud \ud Data from the Longitudinal Study of Australian Children (LSAC) were analysed to address the research aim. The LSAC follows two cohorts of children (infants aged 0/1 years – B cohort, n = 4242; and children aged 4/5 years – K cohort, n = 4169) collecting data in 2004, 2006, 2008 and 2010. In B cohort at baseline 3.7% (n = 189) of the sample were reported by their parent to have had an ear infection (excluding hearing problems) and 0.5% (n = 26) were reported by their parent to have hearing problems (excluding ear infections). 6.7% (n = 323) of the K cohort were identified as having had an ear infection and 2.0% (n = 93) to have hearing problems. Psychosocial outcomes were measured using the Strengths and Difficulties Questionnaire. Data were analysed using multivariate analysis of variance and logistic regression, reporting adjusted odds ratio and 95% confidence intervals of the association between reported ear infections (excluding hearing problems)/or hearing problems (excluding ear infections) and psychosocial outcomes.\ud \ud Results\ud \ud Children were more likely to have abnormal/borderline psychosocial outcomes at 10/11 years of age if they had been reported to have ongoing ear infections or hearing problems when they were 4/5 years old. When looking at the younger cohort however, poorer psychosocial outcomes were only documented at 6/7 years for children reported to have hearing problems at 0/1 years, not for those who were reported to have ongoing ear infections.\ud \ud Conclusion\ud \ud This study adds further evidence that a relationship may exist between repeated ear infections or hearing problems and the long-term psychosocial health of children and provides support for a more systematic investigation of these issues

Avoidability of hospital deaths and association with hospital-wide mortality ratios: retrospective case record review and regression analysis.

OBJECTIVES: To determine the proportion of avoidable deaths (due to acts of omission and commission) in acute hospital trusts in England and to determine the association with the trust's hospital-wide standardised mortality ratio assessed using the two commonly used methods--the hospital standardised mortality ratio (HSMR) and the summary hospital level mortality indicator (SHMI). DESIGN: Retrospective case record review of deaths. SETTING: 34 English acute hospital trusts (10 in 2009 and 24 in 2012/13) randomly selected from across the spectrum of HSMR. MAIN OUTCOME MEASURES: Avoidable death, defined as those with at least a 50% probability of avoidability in view of trained medical reviewers. Association of avoidable death proportion with the HSMR and the SHMI assessed using regression coefficients, to estimate the increase in avoidable death proportion for a one standard deviation increase in standardised mortality ratio. PARTICIPANTS: 100 randomly selected hospital deaths from each trust. RESULTS: The proportion of avoidable deaths was 3.6% (95% confidence interval 3.0% to 4.3%). It was lower in 2012/13 (3.0%, 2.4% to 3.7%) than in 2009 (5.2%, 3.8% to 6.6%). This difference is subject to several factors, including reviewers' greater awareness in 2012/13 of orders not to resuscitate, patients being perceived as sicker on admission, minor differences in review form questions, and cultural changes that might have discouraged reviewers from criticising other clinicians. There was a small but statistically non-significant association between HSMR and the proportion of avoidable deaths (regression coefficient 0.3, 95% confidence interval -0.2 to 0.7). The regression coefficient was similar for both time periods (0.1 and 0.3). This implies that a difference in HSMR of between 105 and 115 would be associated with an increase of only 0.3% (95% confidence interval -0.2% to 0.7%) in the proportion of avoidable deaths. A similar weak non-significant association was observed for SHMI (regression coefficient 0.3, 95% confidence interval -0.3 to 1.0). CONCLUSIONS: The small proportion of deaths judged to be avoidable means that any metric based on mortality is unlikely to reflect the quality of a hospital. The lack of association between the proportion of avoidable deaths and hospital-wide SMRs partly reflects methodological shortcomings in both metrics. Instead, reviews of individual deaths should focus on identifying ways of improving the quality of care, whereas the use of standardised mortality ratios should be restricted to assessing the quality of care for conditions with high case fatality for which good quality clinical data exist

Social inclusion for children with hearing loss in listening and spoken Language early intervention: an exploratory study

Background: Social inclusion is a common focus of listening and spoken language (LSL) early intervention for children with hearing loss. This exploratory study compared the social inclusion of young children with hearing loss educated using a listening and spoken language approach with population data. Methods: A framework for understanding the scope of social inclusion is presented in the Background. This framework guided the use of a shortened, modified version of the Longitudinal Study of Australian Children (LSAC) to measure two of the five facets of social inclusion ('education' and 'interacting with society and fulfilling social goals'). The survey was completed by parents of children with hearing loss aged 4-5 years who were educated using a LSL approach (n = 78; 37% who responded). These responses were compared to those obtained for typical hearing children in the LSAC dataset (n = 3265). Results: Analyses revealed that most children with hearing loss had comparable outcomes to those with typical hearing on the 'education' and 'interacting with society and fulfilling social roles' facets of social inclusion. Conclusions: These exploratory findings are positive and warrant further investigation across all five facets of the framework to identify which factors influence social inclusion

First-order melting of a weak spin-orbit Mott insulator into a correlated metal

The electronic phase diagram of the weak spin-orbit Mott insulator (Sr(1-x)Lax)3Ir2O7 is determined via an exhaustive experimental study. Upon doping electrons via La substitution, an immediate collapse in resistivity occurs along with a narrow regime of nanoscale phase separation comprised of antiferromagnetic, insulating regions and paramagnetic, metallic puddles persisting until x~0.04. Continued electron doping results in an abrupt, first-order phase boundary where the Neel state is suppressed and a homogenous, correlated, metallic state appears with an enhanced spin susceptibility and local moments. As the metallic state is stabilized, a weak structural distortion develops and suggests a competing instability with the parent spin-orbit Mott state.Comment: 5 pages, 4 figure

"...they should be offering it": a qualitative study to investigate young peoples' attitudes towards chlamydia screening in GP surgeries

<p>Abstract</p> <p>Background</p> <p>Despite the known health and healthcare costs of untreated chlamydia infection and the efforts of the National Chlamydia Screening Programme (NCSP) to control chlamydia through early detection and treatment of asymptomatic infection, the rates of screening are well below the 2010-2011 target rate of 35%. General Practitioner (GP) surgeries are a key venue within the NCSP however; previous studies indicate that GP surgery staff are concerned that they may offend their patients by offering a screen. This study aimed to identify the attitudes to, and preferences for, chlamydia screening in 15-24 year old men and women attending GP surgeries (the target group).</p> <p>Methods</p> <p>We undertook 36 interviews in six surgeries of differing screening rates. Our participants were 15-24 year olds attending a consultation with a staff member. Data were analysed thematically.</p> <p>Results</p> <p>GP surgeries are acceptable to young people as a venue for opportunistic chlamydia screening and furthermore they think it is the duty of GP surgery staff to offer it. They felt strongly that it is important for surgery staff to have a non-judgemental attitude and they did not want to be singled out as 'needing' a chlamydia screen. Furthermore, our sample reported a strong preference for being offered a screen by staff and providing the sample immediately at the surgery rather than taking home a testing kit. The positive attitude and subjective norms demonstrated by interviewees suggest that young peoples' behaviour would be to accept a screen if it was offered to them.</p> <p>Conclusion</p> <p>Young people attending GP surgeries have a positive attitude towards chlamydia screening and given the right environment are likely to take up the offer in this setting. The right environment involves normalising screening by offering a chlamydia screen to all 15-24 year olds at every interaction with staff, offering screening with a non-judgemental attitude and minimising barriers to screening such as embarrassment. The GP surgery is the ideal place to screen young people for chlamydia as it is not a threatening place for them and our study has shown that they think it is the normal place to go to discuss health matters.</p

Science Librarian Internship as a Way to Get Started in EScience

The Science Bibliographers’ Group of Boston College first proposed the creation of a paid science librarian internship position in Summer 2008. Since then, the three interns hired over time have gained exposure to a wide variety of activities undertaken by science librarians, and, at the same time, have significantly furthered the Library’s understanding of, and participation in, eScience. In addition to important contributions in reference and collection development activities, intern contributions have included an environmental scan/best practices review of relevant eScience initiatives, design of an eScience brochure, development of a faculty survey to gauge interest in library data management, and a capstone presentation on eScience for all library staff. Building upon that work, the Science Bibliographers’ Group developed a Vision Statement and Action Plans for eScience. Our current intern is working closely with members of the group on the creation of a LibGuide focused on data management and, concurrently, develop-ment of curricular materials for data management workshops to be implemented during the 2011/12 academic year. Ideally, these increased efforts in eScience-related work will result in an enhanced profile for eScience on the Boston College campus, and, ultimately, creation of a new, eScience-focused position in the Boston College Libraries. An internship program can provide current knowledge and skills to educate and support a university research library through the early learning stage of developing an eSciences program, while simultaneously providing a valuable hands-on learning experience for a potential science librarian

Tropical larval and juvenile fish critical swimming speed (U-crit) and morphology data

Fish swimming capacity is a key life history trait critical to many aspects of their ecology. U-crit (critical) swimming speeds provide a robust, repeatable relative measure of swimming speed that can serve as a useful surrogate for other measures of swimming performance. Here we collate and make available one the most comprehensive datasets on U-crit swimming abilities of tropical marine fish larvae and pelagic juveniles, most of which are reef associated as adults. The dataset includes U-crit speed measurements for settlement stage fishes across a large range of species and families obtained mostly from field specimens collected in light traps and crest nets; and the development of swimming abilities throughout ontogeny for a range of species using reared larvae. In nearly all instances, the size of the individual was available, and in many cases, data include other morphological measurements (e.g. “propulsive area”) useful for predicting swimming capacity. We hope these data prove useful for further studies of larval swimming performance and other broader syntheses